About Gden-River

Gden-River Health and Safety Services Limited (GRHSS) is a duly registered company with Registration No.80020003897181. GRHSS was established to support and promote the provision of emergency health care services to further improve the health of the Ugandan population and contribute towards the realization of Universal health coverage as envisioned in the Third National Health Policy (NHP III) and the Sustainable Development Goals especially Goal NO.3 (attainment of Good health and wellbeing for all at all ages by 2030).

The primary focus of GHRSS is to further enhance the responsiveness of the health system to provide emergency health care services and also build the capacity of community’s / key institutions in preserving life, preventing harm, promote recovery and relief of patients in pain. It also aims at mitigation, preparedness, response and recovery.

What We Offer

GRHSS offers the following services; provision of emergency first aid services. This service is made up of medical First responders, Emergency medical technicians and paramedicals. Crews respond to all medical emergencies eg motor vehicle accidents, fires or other traumatic events in coordination with Emergency services department of the Ministry of Health (MOH) ; training and skills development on emergency medical care for key targeted beneficiaries (First Aid and CPR, Training of trainers, medical first responders, training of paramedics in community paramedicine, safe driving etc. ), provision of essential medical products and technologies for delivery of emergency care services, provision/ maintenance of appropriate infrastructure /equipment’s for delivery of EMS, awareness creation on First Aid and CPR Skills, provision of relief items and mobilization of civil society efforts to promote First Aid and CPR Skills among communities.

Our Vision

Our vision is to empower communities through access to quality healthcare, education, and emergency response.

We aim to:

Provide free medical screenings and treatment to those in need
Train individuals in first aid and CPR to save lives and prevent injuries
Build affordable hospitals to increase access to medical care

By achieving this vision, we hope to create a world where everyone has the opportunity to live a healthy and fulfilling life, regardless of their background or financial situation.

Executive Summary

The project seeks to support and promote provision of accessible and affordable emergency medical services to further improve the health of the Ugandan population and contribute towards realization of universal health coverage by 2030.

The objectives of the project are to; save lives through provision of emergency first aid services; ensure dedicated human resources for emergency care through provision of community based training and skills development ; ensure adequate provision of essential medical products and technologies for delivery of emergency care services; maintain appropriate infrastructure /equipment’s for delivery of Emergency Care services; and raise awareness campaigns through mobilization of civil society efforts to promote First Aid services in the country.

The project will be community based and thus will be integrated within the existing community structures in the areas of operation.

The anticipated project deliverables include among others; Improved access to Emergency Medical services, decreased mortality and disability from all forms of emergencies, trauma (injury), maternal, infectious diseases and complications from non- communicable diseases such as hypertension, stroke and cardiac arrests Increased utilization of CPR/ First Aid services, Increased awareness of EMS services, Decreased expenditure on health care and Improved household incomes.

We are in partnership with the Ministry of Health to provide medical emergency services and training to the community.

Our Founder & President

Isaac Mukwaya

He is an American Red Cross instructor and the founder of Goshea Healthcare Staffing Agency in Massachusetts, USA.

Emergency medical system components
GRHSS emergency medical system is made up of many components. These include: Emergency Medical Crews/teams, firefighters, Hospital staff, dispatch centers etc. Emergency medical crews are made up of medical First responders who are trained in basic First aid, CPR and operations of the emergency system and Emergency Medical Technicians who are trained and specialized in the treatment of all types of medical traumatic injuries.

Project operational areas
The project is being piloted in Kampala metropolitan area and will be expanded to Mukono and Jinja Districts given their location on the highway. After a successful pilot execution of her programs, the project will duplicate the same model of operation to cover other areas in the country.

What is our capacity?
GRHSS has a Board of Directors (BOD) composed of competent board members with the requisite experience and background in emergence medical services drawn from various organizations with relevant specialties in emergency care.
The Project has a signed Memorandum of Understanding (MOU) with the Ministry of health (Attached as annex 1) and works closely with the Emergency Medical Services Department and other stakeholders in emergency Care and also has a cordial working relationship with the political and technical leadership of the Ministry of health at National and subnational levels.

The project boasts of well qualified and dedicated staff by all categories in emergency care from within the project and Ministry of health which are competent to deliver on the intended outputs of the project.

GRHSS is a community based organization and uses a participatory approach in provision of emergence health care services. GRHSS considers the community as a very essential partner in the rural transformation efforts. This synergy will be utilized to ensure successful implementation of the project. In addition, the project has some elaborate sustainability arrangements.

SITUATION ANALYSIS
Uganda is among the top-ranking countries for Road Traffic Injuries along with South Africa, Nigeria, Iran, Thailand and Dominican Republic. According to the annual traffic and crime reports of the Uganda Police Force, an average of 3,000 victims were killed and an average of 12,000 victims were seriously injured due to Road Traffic Accidents (RTAs) between 2011 and 2016.

The urban population is at a higher risk than the rural population, especially due to the rise of the boda boda industry. On average Mulago National Referral hospital admits over 800 cases of trauma cases monthly and 75-80% of these are due to Road traffic injuries and 60% of the RTIs are due to boda-boda accidents. Young adults, in their productive years, are disproportionately affected more by trauma.

The 2018, Uganda road safety performance review showed that on average, the country loses 10 people per day in road accident traffic crashes, which is the highest level in East Africa. The overall annual cost of road crashes is currently estimated at approximately UGX 4.4 trillion ($1.2 billion), representing 5% of Uganda’s gross domestic product (GDP). Natural disasters result in damages constituting between 2% to 15% of an exposed country’s annual Gross Domestic Product (GDP).

The Uganda traffic and road safety report 2017 and the recent annual Health Sector performance reports have clearly indicated that there is an increase in mortality rates due to the growing number of road traffic injury related emergencies and sets the need for Ministry of Health to plan for Post-crash response as guided by the UN Decade of Action on Road safety (2021-2030).

Uganda is also experiencing an increase in non-communicable diseases such hypertension, diabetes, cardiac disorders and sickle cell disease with rising incidents of emergencies like stroke and cardiac arrests. Communicable public health emergencies like Ebola, Marburg and Cholera are a common occurrence in Uganda.

Obstetric and neonatal emergencies significantly contribute to the burden of emergencies, with an estimated 16 maternal deaths per day and 40,000 stillbirths occurring each year in Uganda. The Uganda Demographic Health Survey Report (UDHS) 2016 showed a high maternal mortality ratio of 336/100,000.

Neuropsychiatric (mental health) emergencies have also had a toll on the Ugandan population with most of the mentally challenged people left unattended to on the streets and health facilities.

At health facility level, all Hospitals and Health Centers (HCs) are not adequately equipped and staffed to deal with patients requiring emergency care. The Uganda Hospital and Health Center IV Census Survey (2014) reported that capacity to offer emergency services at hospitals/ HC IVs is generally poor, with only 5% and 25% of the hospitals/HC IVs classified as having very good and good capacity respectively.
The rest of the hospitals/ HC IVs were classified as having moderate (38%), poor (35%) and very poor capacity (5%). At Health centre IVs, General Hospitals and Regional referral hospitals, there was lack or shortage of medical equipment necessary for assessment of patients presenting with emergency conditions. There are limited numbers of emergency care specialist health workers at the facilities. Patients experience delays in receiving care due to the requirement for pay before receiving care in the private facilities that have fee-for service arrangements

At community level, the knowledge and capacity to provide first aid is limited. There are few trained first responders in the country. Inadequate number of first responders, poor quality of first aid delivery and limited functional ambulances with dedicated emergency providers are the key delays in accessing critical pre-hospital emergency care. It was also found that in congested urban areas and hard to reach rural areas formal care was not immediately available.

Regarding ambulance services, the country has rudimentary ambulance network that attempts to respond and rescue emergency victims. The current ambulance network consists of many forms of ownership such as government (Ministry of Health, Police & Local Governments), Private not for Profit Health sub-sector (PNFP health Units), Private health units, Members’ of Parliament, Charity organizations and private agency ambulance providers that are not coordinated.

The Government of Uganda has established a functional and integrated Emergency Medical Services (EMS) system in Uganda being Coordinated by the Emergency Medical Services Department Under the Ministry of health. However, there are currently insufficient investments in EMS from out of hospital emergency care (OHEC) to hospital emergency care.

GHRSS has therefore, been established to support Ministry of health Uganda to promote and enhance the responsiveness of the health system to provide emergency health care services and also build capacity of community’s / key institutions in preserving life, preventing harm, promote recovery and relief of patients in pain to contribute to attainment of universal health coverage in Uganda by 2030 and realization of Sustainable Development Goal 3.